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Communtity Law Manual | Gender & sexuality | Gender-affirming surgery and treatment

Gender and gender identity

Gender-affirming surgery and treatment

Can I get access to genital reconstruction surgery?

Guidelines for gender affirming healthcare for gender diverse and transgender children, young people and adults in Aotearoa, New Zealand. Transgender Health Research Lab, University of Waikato, 2018.

There is some access to publicly funded genital reconstruction surgery in New Zealand, but it is currently limited, with a very long waiting list.

The specific types of reconstruction surgery available are metoidioplasty or phalloplasty (masculinising) and vaginoplasty (feminising).

Access to this surgery is through the Ministry of Health (MOH), rather than local District Health Boards. Between 2014–2018, there were not any surgeons in New Zealand who could do this surgery, and therefore people have been funded to have the surgery overseas under the MOH High Cost Treatment Pool. However, as of 2018, there is now a surgeon in New Zealand who can perform these surgeries locally.

To access this surgery you’ll need to get a DHB specialist to refer you on to the MOH‘s High Cost Treatment Pool. The specialist could be a sexual health doctor, or an endocrinologist (a specialist in hormone-related issues). You can start the process by talking to your usual GP and asking them to refer you to a specialist, who can then refer you on to the Ministry of Health.

There is reportedly a 30-year waiting list for this surgery. To address this, the government announced in May 2019 that it had allocated $3 million to increase access.

Can I get access to other types of gender-affirming medical treatment?

Guidelines for gender affirming healthcare for gender diverse and transgender children, young people and adults in Aotearoa, New Zealand. Transgender Health Research Lab, University of Waikato, 2018.

According to the Guidelines for gender affirming healthcare, you can get access to some other kinds of gender-affirming treatment within New Zealand under the public health system. This will depend on what’s provided by the District Health Board (DHB) for your area.

The DHB may be able to provide you with treatment such as:

  • chest surgery (chest reconstruction to masculinise, or a breast augmentation to feminise where there has been no response to oestrogen)
  • a hysterectomy (removal of the uterus)
  • an oophorectomy (removal of ovaries)
  • an orchidectomy (removal of testicles)
  • plastic surgery, such as laryngeal shaves (Adam’s apple reduction) and facial feminisation.

If you’re not satisfied with your access to gender-affirming medical treatment, you can complain under the healthcare Code of Rights (see the chapter “Disability rights”, under “Health and disability services: Your rights and how to enforce them”) or under the anti-discrimination laws (see the chapter “Discrimination”, under “Taking action”).

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